Individual
DEJUANNA OUBRE CORSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, APRN
Contact information
Practice address
13148 VAIL RIDGE DR, RIVERVIEW, FL 33579-7187
(813) 317-3930
(813) 317-3930
Mailing address
5222 LAKE TOSCANA DR, WIMAUMA, FL 33598-4433
(813) 317-3930
(813) 790-6492
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9636578
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11040570
FL
Other
Enumeration date
05/08/2025
Last updated
09/30/2025
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